The study, which appears in the July 1 issue of the American Journal of Public Health, is authored by University of Maryland School of Nursing professors Alison Trinkoff (Department of Family and Community Health) and Meg Johantgen (Department of Organizational Systems and Adult Health) and Carlos Muntaner, currently a University of Toronto professor and a scientist at Toronto's Centre for Addiction and Mental Health.
The researchers examined injury and staffing data for three U.S. states: Maryland, West Virginia and Ohio. For each additional hour of nursing care provided, injury rates for nurses and nurses' aides fell by nearly 16 per cent. In other words, for every unit increase in staffing, worker injury rates decrease by two injuries per 100 full time workers.
"Our findings were consistent across states, despite differences in data collection, classification of injuries and reporting procedure," says Trinkoff. "This information is valuable, because as health-care institutions have been asked to perform more efficiently, changes have led to lower staffing and higher patient loads, which lead to worker injury."
The researchers controlled the data to examine differences between for-profit and not-for-profit homes. Profit status was not significantly related to worker injury, once they accounted for state, facility size and staffing levels. However, for-profit homes generally have higher nursing turnover and lower staffing levels, which correlate with injuries, says Muntaner.
With more than 1.5 million elderly Americans residing in nursing homes and a population that is aging, nursing injuries take on an increasing importance, adds Muntaner. They can be viewed as a warning sign. "If residents are treated by workers who are injured, the quality of care suffers, and there is also the problem of high turnover rates," Muntaner says.
Muntaner believes the data have implications for Canadian health care, too.
"As we move toward the further privatization of health care, we will see more of this," he says. "Reductions in staffing ratios and numbers of staff hours lead to lower quality of care. At the end of the day, it's a policy option, but the consequences are clear. If you try to squeeze the budget to maximize profits, it creates the dangerous situation we see in the United States."